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Do you have to have therapy to address past trauma in order to recover from depression and anxiety?

Given this is a column about therapy, then of course the answer is yes! Actually, the answer is that it depends, but I'll get to that later...

Firstly, it depends on how you define "trauma". Usually, people think of it as a threat to life and limb: Getting shot at, beaten up, raped, surviving a plane crash... these things are undoubtedly traumatic, but a useful definition of trauma is one which focuses on impact: Trauma is any event that overwhelms our capacity to cope emotionally.

It's also true that exceeding our capacity to cope is affected by both our capacity to cope, and the intensity of the event. We see this in more obvious trauma all the time. Not everyone who survives a plane crash or goes to war is traumatised by it.

This is also true of childhood. All sorts of things impact a person's ability to cope: Genes, temperament, and the quality of early bonding with parents. All these vary from child to child, even sibling to sibling.

Despite what the pharmaceutical companies might want us to believe, mental illness is not a biological illness. It is in fact a complex interplay between our genes, temperament and events that impact our emotional development. In other words, trauma.

So trauma is subjective, but it also depends on how the people around us respond to the events that upset and overwhelm us. This is particularly problematic and damaging if the source of the trauma is those we would naturally turn to for support when upset: Our parents.

But trauma isn't always "child abuse," sometimes it can be as subtle as an anxious child who keeps their anxiety hidden for fear of not being understood. Or an emotional child who gets compared unfavourably to a more resilient sibling.

It's also true that bullying, social problems and normal life events like moving house or schools affect some kids more than others (it depends, remember?).

Back to your question: Do you have to have therapy? Like I said, it depends largely on how well your capacity to cope with things emotionally is stacking up. And guess what one of the most effective things you can do to help increase your capacity to cope with difficult emotions is? Psychotherapy.